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Newsline: Everything you need to know about Issue 2

November 3, 2017

Election day is Tuesday, November 7! To find your polling location, click here. OPA's Board of Trustees highly encourages you to get out and vote!

Of all the offices and issues on the ballot, no initiative has received more attention than Issue 2. And as we're sure many of you know, the public is looking to pharmacists for their opinion and counsel on a confusing proposal that promises lower drug prices, but of course, the devil's in the details. For a complete breakdown and analysis from OPA, click here, and see below for a series of videos, debates, editorials, news stories and more.

Members of the Ohio Pharmacists Association know all about how dysfunctional the prescription drug supply chain is, and we know reform is desperately needed. Issue 2 is the right diagnosis, but the wrong prescription.

We continue to pursue rational drug pricing reform that shines light on opaque pricing gimmicks and billion-dollar middlemen that stifle true competition and profit off of higher list prices. The system is broken, and many Ohioans are broke because of it.

Issue 2 would double down on the same backwards policies that have resulted in the outrageous drug prices we're seeing today. It won't yield the savings that proponents promise, and it will likely result in decreased access, countless lawsuits, and higher drug prices for millions of Ohioans. We've studied this proposal extensively. There is no doubt about it: Ohioans should completely reject Issue 2.

Read our case against the measure. The Ohio Pharmacists Association strongly urges a NO vote on Issue 2.

OPA leads the charge against Issue 2

OPA Board Trustee Deb Randall: How should I vote on Issue 2?
Lima News
OPA Board Trustee Deb Randall writes in the Lima News: "As a pharmacist, I know people are concerned with being able to afford their medicine. I also know that things that sound too good to be true usually are, and that’s certainly the case with Issue 2. Proponents claim that Issue 2 will save taxpayers millions of dollars and make prescription drugs cheaper. But experts who have studied the issue — including a former state budget director and three former Ohio Medicaid directors who served in both Democratic and Republican administrations — say it is likely to do the exact opposite, raising drug costs for the majority of Ohioans and reducing access to needed medicines for some of our most vulnerable citizens."

OPA Executive Director Ernie Boyd engages in debate over state question dealing with drug prices
Sandusky Register
Drug companies are terrified voters will approve a state question to limit the costs of prescription drugs, according to supporters of Issue 2. Passage, they said, would launch a series of similar efforts to finally end price gouging by pharmaceutical companies. These advocates stressed this message to a crowd of about 300 people recently at the Sandusky Community Church of the Nazarene. But that’s simply nonsense, opponents insisted: The pharmacy industry, dozens of organizations which oppose the state question, and state newspapers that have lined up against it realize it simply won't work, they said. OPA Executive Director Ernie Boyd debates Issue 2 proponents and exposes the fundamentals flaws in the initiative.

OPA 2017 Midyear Meeting

Health Matters radio show: OPA Government Affairs Director Antonio Ciaccia talks Issue 2 with Paul & Brad White
Health Matters
Voting day is next week, and there is a lot of chatter about Issue 2, which has been dubbed the "Deceptive Rx Issue." Will you vote no or yes? To help you get a better understanding of what is at stake, OPA members and Health Matters hosts Paul & Brad White talk about what Issue 2 is, how it will affect individuals and families, and find out how the actual ballot language reads, as well as dig into what it all means. Antonio Ciaccia, Director of Government and Public Affairs for OPA join Paul & Brad to discuss the facts.

Which side should we believe in battle over Ohio drug prices?
Columbus Dispatch
Tracy Jones got involved in the Drug Price Relief Act campaign to lower drug prices because her aunt had to choose between a cheap antibiotic and another drug that cost $126 a month. Getting by on a $600 a month fixed income, Jones’ aunt chose the antibiotic — and lost sight in one eye as a result. “People are really struggling,” said Jones, who works for the AIDS Healthcare Foundation, the California group sponsoring a ballot issue that will appear on Ohioans’ Nov. 8 ballots. “Here’s an opportunity for us to do something that could affect the country nationwide, and it starts here in Ohio.” Antonio Ciaccia, head of government affairs for the Ohio Pharmacists Association, is sympathetic to consumer worries about soaring drug prices. But he opposes the Drug Price Relief Act, already the topic of ad campaigns expected to be among the most expensive in Ohio history.

Side Affects: The Ohio Drug Price Relief Act
Side Affects podcast
OPA Past President Jeff Bartone and OPA government affairs director Antonio Ciaccia discuss the problems with the Ohio Drug Price Relief Act on the latest edition of the Side Affects podcast, hosted by Scott McGohan and Anne Marie Singleton. This is OPA's second appearance on the Side Affects show - the last appearance focused heavily on the role PBM in drug pricing. Please listen to this recent episode to learn how the ballot initiative could impact pharmacies, employers, and patients.

Opposing the Ohio Drug Price Relief Act
Equitas Health
OPA has several member pharmacists who practice at Equitas Health (formerly AIDS Resource Center Ohio), a regional not-for-profit community-based healthcare system founded in 1984. The Equitas Health Pharmacy operates as a social enterprise for Equitas Health and is one of the pillars of the healthcare organization’s patient-centered care model. Our partners at Equitas Health have been incredibly great to work with as we worked to oppose Issue 2. Specifically OPA members Aaron Clark and Phil Pauvlinch are both featured in several ads against the initiative. Read Equitas Health's case against Issue 2 here.

"The ballot proposal is not only unworkable but could actually end up increasing drug costs for state programs and the majority of Ohioans, while also reducing patients’ access to needed medications."

OPA's Antonio Ciaccia discusses Issue 2 with America's Work Force Radio
America's Work Force Radio
In September, OPA government affairs director Antonio Ciaccia joined Frank Mathews, host of America's Work Force Radio on WERE-AM Cleveland, to discuss OPA's opposition to Issue 2, the Ohio Drug Price Relief Act. Listen here at minute 43.

Yes vs. No on Issue 2: What they’re saying on both sides
Dayton Daily News
The Ohio Drug Price Relief Act — Issue 2 on the November ballot — has caused plenty of debate. It would require that the state, including the Ohio Department of Medicaid, pay the same or lower prices for prescription drugs as the U.S. Department of Veterans Affairs — which currently negotiates drug prices at least 24 percent less than other agencies. Here are views from both sides of the issue, including OPA member Nnodum Iheme and OPA Executive Director Ernie Boyd.

OPA's Antonio Ciaccia argues against Issue 2 on 10TV's Face the State
WBNS 10TV Columbus
This week, OPA government affairs director Antonio Ciaccia joined 10TV's Face the State to discuss the misguided Issue 2 ballot proposal that could result in drug price increases for millions of Ohioans. Hosted by Scott Light, discussion centered around the flawed premises of the ballot initiative, the role of the PBM in raising drug prices, and the likelihood of cost-shifting if Issue 2 passes.

Issue 2: What you need to know before you vote
FOX 45 Now
One of the issues voters will be deciding this November is Issue 2, which deals with prescription drug pricing. You've not doubt seen commercials on TV urging you to vote "yes" or vote "no" on Issue 2. The problem is that for many, the issue is confusing. FOX 45 sat down with OPA Past President Marc Sweeney from Cedarville University on Monday morning. He's the Dean of the School of Pharmacy at Cedarville. Sweeney explained the issue and what voters need to know before they go to the ballot box. 

Battle over Issue 2 heats up
WFMJ Youngstown
The debate is heating up over Issue 2, the statewide ballot initiative designed to lower drug prices in Ohio. The ads are flooding Ohio TV airwaves and social media; some with promises, others with warnings tied to the Ohio Drug Price Relief Act. OPA government affairs director Antonio Ciaccia joins WFMJ's Lindsay McCoy to discuss OPA's opposition to Issue 2.

Pharmacist Ray Carlson discuss Issue 2, pharmacist workloads, PBMs and more with Louie B. Free: Part 1, Part 2
Facebook Live
This week, OPA Past President Ray Carlson sat down with radio host Louie B. Free to discuss the flawed premises of Issue 2, and the problems associated with price controls, PBM rebates, and the collateral damage of the race to the bottom on prescription drug spending. This is a two-part Facebook Live interview. Check out Part 1 and Part 2.

Locals: Lower drug prices good, Issue 2 not so much
Bellefontaine Examiner
Probably the most controversial issue on the Nov. 7 ballot is the one proponents say could be a game changer in the skyrocketing costs of prescription drugs. While proponents say the Drug Price Relief Act could save Ohio taxpayers up to $400 million a year, the opposition, funded by the nearly $100 billion annual marketing budget of the pharmaceutical manufacturing industry, are challenging that and other claims in a multi-million advertising campaign. OPA member Jeff Holycross explains how Issue 2 mistakenly avoids one of the primary cost-drivers for prescription drugs: pharmacy benefit managers.

OPA featured in ad against Issue 2
The Ohio Pharmacists Association is part of a massive coalition of organizations that are opposed to Issue 2. In this campaign ad, OPA is prominently featured with the Ohio State Medical Association and the Ohio Nurses Association as core groups that represent Ohio's health care providers.

OPA Past Presidents featured in ad opposing Issue 2
OPA Past Presidents Steve Burson and Jeff Bartone are featured in a recent ad highlighting a number of health care professionals who are united in their opposition to Issue 2.

Newspapers and news agencies line up in opposition to Issue 2

Akron Beacon Journal
"Issue 2 is poorly constructed, so much so that it offers no practical prospect of delivering what it promises. If anything, the result would be a prolonged mess. We recommend a 'no' vote on Issue 2 on Nov. 7."

Sandusky Register
"Sounds great, right? Even the name of the measure — Drug Price Relief Act — is enticing. Who doesn’t want to pay less for prescription drugs? Well, the saying ‘if it sounds too good to be true, it probably is’ has never rang truer than with Issue 2."

Columbus Dispatch
"And we asked ourselves honestly: Could this be good for Ohio? Our answer: Issue 2 is fraught with risk and unlikely savings, the claims for which vacillate between $164 million and $536 million. A misleading and untruthful campaign has done nothing to argue for its cause."

Newark Advocate
"Issue 2 would not change the amount the pharmacy pays for the drug, but would restrict the amount a state-funded health plan could reimburse the pharmacy. This is why the Ohio Pharmacists Association is against the measure. They fear they will have to take a loss on many prescriptions filled for Medicaid patients. Something they say is already happening, and forcing community pharmacies to close."

Lisbon Morning Journal News
"Assume for a moment that pharmaceutical companies do grant additional discounts to government buyers. Can anyone but the most naive believe the firms will not increase prices charged to private consumers in order to make up their losses on state contracts?"

Canton Repository
"Issue 2 proponents are correct when they say, 'In one way or another, every state is going to have to address the high cost of prescription drugs.' Absolutely true. This, however, isn’t the way."

Ashtabula Star Beacon
"On a deeper scale, the largest problem with Issue 2 is that it is an a la carte approach to health care reform. Health care is such a complex and interwoven tapestry that even if Issue 2 were guaranteed to be successful in lowering drug prices, pulling on one thread without reforming other parts of the health care system could have unforeseen — and expensive — consequences. The health care system needs to be fixed as a whole, not piecemeal."

Cleveland Plain Dealer
"Drug companies ought to be reined in. But passing a statute that is impractical, litigation-prone and that's likely to do little to address the problem of overpriced drugs isn't the answer. That's why Issue 2 is a problem, not a cure."

WCPO Cincinnati
"Drug pricing is a complicated puzzle influenced by insurance companies, employers, contracts and competition. Does it need more scrutiny and transparency? Yes. But a simplistic effort like Issue 2 is not the way to go about it."

Findlay Courier
"We’re sympathetic to those struggling with the high costs of health care and medicine, and troubled by reports that the U.S. often pays more for medications than other countries, even though most meds used by Americans were developed here. But it’s questionable if Issue 2 would solve or exacerbate the problem."

Parkersburg News and Sentinel
"Clearly, Issue 2 is bad medicine for Ohioans, who ought to say no to it Nov. 7."

Crain's Cleveland Business
"Because Issue 2 deals with health care paid for by the state — which already aggressively negotiates drug pricing — the vast majority of Ohioans will not see the cost of their drugs decrease. In fact, because of simple economics, they might even see their costs increase as pharmaceutical companies shift the burden to those with private insurance."

Warren Tribune Chronicle
"Proponents say government retirees would be covered. But officials of the state’s five retirement programs say they would not. That could set up a costly court battle to settle the question — and that is among the more devious aspects of Issue 2. The fine print requires taxpayers to cover the costs of any legal action involving the program."

Wheeling News-Register
"Only a handful of organizations have endorsed the plan. Meanwhile, scores of others oppose it."

More Issue 2 coverage

Why Ohio’s medical community says vote no on Issue 2
USA Today
Ohio doctors, nurses and pharmacists warn that Issue 2 could increase patients’ prescription drug costs and reduce access to important medicine.

Issue 2 FAQ: What you need to know before you vote
Cleveland Plain Dealer
If you're confused about Ohio Issue 2 on the November ballot, welcome to the club. The campaigns for and against Issue 2 have been divisive, puzzling and even misleading. Recently, the Cleveland Plain Dealer asked readers whether they fully understood the ballot initiative. By an overwhelming margin, Issue 2 and its possible effects weren't entirely clear. At, they have explained aspects of Issue 2 through their reporting - including fact checking and insight into who is behind the campaigns. With this piece, they've set out to give more context to the Issue 2 debate, including answering questions you might have before heading to the polls.

Why doctor and hospital groups are fighting a measure to rein in drug costs
In recent years, doctors nationwide have lamented ever-rising drug prices that are limiting patient access to crucial medicines and undermining hospital finances. But a ballot initiative in Ohio is flipping that script. Several prominent physician and hospital groups are joining pharmaceutical companies to oppose a proposal to rein in drug costs paid by state agencies. Their reasoning? Drug makers, wholesalers, and pharmacies will actually raise prices on most Ohioans if the state takes a mandatory discount.

State concludes Issue 2 won’t likely result in savings
Dayton Daily News
State Issue 2 is unlikely to result in any savings for Ohio’s Medicaid program, the state’s budget office concluded in a report that appears to call into question claims by supporters that the initiative will save the state hundreds of millions of dollars on prescription drug prices. Although the report says other programs may see some savings, Medicaid makes up the bulk of the state’s prescription drug spending.

NBC4 leads statewide forum to get the facts on Issue 2
NBC4i Columbus
NBC4 WCMH-TV partnered with broadcast stations across Ohio to host a Statewide Issue 2 Forum aimed at getting the facts about the prescription drug initiative appearing on the upcoming November ballot.

What could Issue 2 mean for you? A closer look at Ohio's drug pricing proposal
WLWT 5 Cincinnati
It's no secret that medicine in America is not cheap. "We're paying four to five times more than any nation in the world, and we consume more than any other nation in the world," said David Little, a communications consultant for Ohio Taxpayers for Lower Drug Prices. Little said Ohio voters can help reign in rising prescription drug costs by voting yes on Issue 2 during the election. "The pharmaceutical industry is terrified that this will pass," he said. Little, a passionate supporter of Issue 2, has been touting the measure statewide. But what would the proposed law do, and why are opponents running ads saying if Issue 2 becomes law, drug prices could actually go up?

Issue 2 fact check: Does Issue 2 cut taxes in Ohio?
Cleveland Plain Dealer
Tax cuts in Issue 2? That's the latest promise from supporters of the ballot initiative that aims to require the state of Ohio to pay no more for pharmaceuticals than the Department of Veterans Administration.  In fact, the issue would do nothing to cut taxes.

Why Ohio employers should care about Issue 2
Dayton Business Journal
This November, Ohioans will be asked to vote on Issue 2, a state-wide ballot initiative that proposes to regulate how state government contracts for prescription drugs. Proponents of Issue 2 claim that the proposed law will protect Ohio taxpayers from the “corporate greed” associated with pharmaceutical companies. While most Ohioans will agree that the costs of prescription medications are too high and pharmaceutical companies seem to be making more money, Issue 2 is not the solution that Ohioans so desperately want.

Ohio Chamber of Commerce slams Drug Price Relief Act
Columbus Dispatch
The Ohio Chamber of Commerce and its statewide business clout is opposing the Ohio Drug Price Relief Act voters will decide this November. Andrew E. Doehrel, president and CEO of the chamber, said the ballot issue is “yet another example of an out-of-state special interest misusing Ohio’s ballot access process in an effort to advance its own interests — at the expense of Ohio citizens and taxpayers. This proposal would almost certainly lead to cost-shifting to private payers, including employers, perversely resulting in a majority of Ohioans paying more, not less, for their prescription drugs.”

How truthful is the EpiPen ad put out by the Yes on Issue 2 campaign?
Cleveland 19 News
Recently you may have seen the latest campaign commercial for the Yes on Issue 2 camp in which two mothers talk about the rising cost of EpiPens which are used to control severe allergic reactions. In the ad the moms talk about the expensive cost of an EpiPen. But is the ad telling the truth?

Outside experts assess Ohio’s ballot issue on prescription-drug prices
Columbus Dispatch
Independent legal and medical experts have mixed opinions about Issue 2, the Nov. 7 ballot proposal aimed at reducing prices on prescription drugs for about 4 million Ohioans. Several experts contacted by The Dispatch who are not affiliated with either the proponents or opponents said Issue 2 could result in some savings on prescription drugs but faces signifcant or even insurmountable hurdles. Others label it as unworkable and say it has the potential to backfire and cause prices to rise and trigger shortages of critical drugs.

Issue 2 pits emotion against complex drug pricing system
Dayton Daily News
Across political lines, Americans in poll after poll say prescription drugs cost too much, and stories abound about patients cutting pills in half or making the difficult choice between their medications and putting food on the table. But while people may agree on the problem, what to do about it has thrust Ohioans in the middle of a big-dollar battleground pitting big pharma against a group that says it has a plan to lower prescription drug prices. Some are arguing that the provisions outlined in the Issue 2 ballot measure could do just the opposite.

Former Ohio Medicaid directors oppose drug price ballot issue
Cleveland Plain Dealer
Three former Ohio Medicaid directors say a November ballot measure intended to lower prescription drug prices would have the opposite effect for most Ohioans. "The money's going to come from some place and this is not the way to do it," John McCarthy, former Medicaid director under Gov. John Kasich, said in a phone call with reporters.

Who is Michael Weinstein, the man behind Issue 2?
Dayton Daily News
With millions of dollars worth of advertising both for and against Issue 2 dominating television airwaves, Ohioans have seen an unfamiliar face as the topic of both criticism and praise.

OPA News

OPA Midyear Meeting - Nov. 5
Ohio Pharmacists Association
Don’t miss out on this energizing opportunity to earn CPE and connect with experts in your profession at the 2017 Midyear Meeting, "Value-based care: Key role for pharmacists." This meeting offers one hour of Pharmacy Law and Rules Update CPE credit to help meet Ohio’s CPE requirement. This program is packed with great sessions. We hope to see you there!

OPA Pies, Pints, & Policy - Nov. 8
Ohio Pharmacists Association
APhA-ASP, SNAPhA, NCPA and OPA are collaborating together to create an advocacy and networking social at Pies and Pints in the Short North in Columbus on November 8th from 6-8pm! Come out and mingle with pharmacists and student pharmacists over some delicious pizza and beer! We will be going over current policies and ways you can get involved in OPA and in our profession! We'll also talk Issue 2! This is also a great opportunity to meet with pharmacists from around Columbus to learn about different job positions, rotations, etc! New practitioners and Columbus-area pharmacists welcome!

Seeking nominations for the State Board of Pharmacy
Ohio Pharmacists Association
Want to make a difference? Then consider applying for the Board of Pharmacy. Annually, the Governor appoints two pharmacists to serve a four-year term, and OPA submits a list of recommendations for the vacancies. The Board's primary purpose is to protect the citizens in the State of Ohio by insuring safe drug distribution. With the practice of pharmacy changing so quickly, your expertise is invaluable to the citizens of Ohio. As a Board Member, you will be involved in licensure, rule making, and disciplinary hearings. You will continually evaluate new technology, standards of practice, and information distribution systems. For a truly rewarding experience, consider applying today.

OPA Pharmacist Legislative Day - Nov. 14
Ohio Pharmacists Association
There are big pharmacy issues this year: pharmacy clawbacks, the opioid epidemic, access to care, provider status, and more! We need your help to stand up for pharmacists! Legislative Day is an advocacy event that allows pharmacists and student pharmacists to meet with legislators to educate them about the value of pharmacists in the world of health care. You will learn about the latest legislative issues in the Ohio Statehouse, discuss ways to effectively communicate those issues, hear from the legislators themselves, and have a chance to individually visit the offices of legislators. This program will allow you to learn and become involved in the issues impacting Ohio pharmacy practice. We’ll discuss pharmacy clawbacks, the opioid epidemic, access to care, provider status, and other critical issues. REGISTRATION NOW OPEN!

Nominate a colleague for the inaugural OPA UNDER 40 Recognition Award
Ohio Pharmacists Association
OPA is pleased to announce the first annual OPA UNDER 40 Recognition program. This program grants young pharmacists the unique opportunity to have their professional achievements highlighted, and allows them to join the ranks of top-notch professionals from a variety of careers who have earned an UNDER 40 award. OPA believes that by recognizing these emerging leaders, a enriched future can be cultivated for the pharmacy profession. In joining forces with various organizations and publications to celebrate Ohio’s “movers and shakers,” OPA is prepared to recognize deserving individuals, who are making a difference in their communities. Within this program, outstanding pharmacists who have exemplified leadership, excellence, and vision in their practice will be honored as distinguished UNDER 40 award recipients at the 2018 OPA Annual Conference. The deadline for submitting nominations is November 21, 2017.

Ohio Pharmacy News

Pharmacy technician registration now available
State of Ohio Board of Pharmacy
The State of Ohio Board of Pharmacy has begun accepting pharmacy technician registration applications. Per Ohio law, all pharmacy technicians practicing in Ohio must be registered with the Board by April 6, 2018. Due to the high volume of expected applicants, it is strongly recommended that current technicians apply for registration well in advance of the deadline. An individual that does not have an active registration by April 6, 2018, will be prohibited from practicing as a pharmacy technician. For more information on the registration process, click here.

Integrated PBM model could pose a threat to hospitals
Modern Healthcare
High-cost hospitals could end up holding the short end of the stick if new integrated pharmacy benefit models take hold.  CVS Health's rumored Aetna takeover bid, tallying $66 billion, could harness 9,700-plus retail stores and more than 1,100 walk-in Minute Clinic locations to funnel patients through lower-cost settings and deliver more comprehensive care by leveraging big data. Such a deal would also bolster CVS Caremark, the retailer's pharmacy benefit management arm, to compete on more equal footing with the likes of UnitedHealth's OptumRx, as well as Anthem's new PBM IngenioRx, which will launch in 2020. Aetna and CVS said they wouldn't comment on rumors and speculation. OPA member and Cleveland Clinic chief pharmacy officer Scott Knoer weighs in on how consolidation will limit competition and raise prices.

Ohio Attorney General Mike DeWine demands money from drug companies – or else
Cincinnati Enquirer
Ohio Attorney General Mike DeWine is demanding a serious offer within 30 days of millions of dollars, maybe even billions, from drug manufacturers and distributors to pay for the state's drug problem – or else. What's the penalty if drug companies don't come forward to pay for DeWine's 12-point plan to address Ohio's crippling drug crisis? He's not saying.

Ohio State research supports benefits of activated charcoal
The Lantern
Many people are looking for that new beauty or health trend that claims to revolutionize how we take care of ourselves. However, it’ can be difficult to decide whether we want to find a new trend for beauty or for health. New studies from the Wexner Medical Center have revealed new and innovative ways of to use charcoal-based powder to absorb toxins that are damaging to the body. Not that this method is to replace standard day-to-day procedures, like taking vitamins, but it is a way to add an extra kick to your health regimen. The main development of charcoal use is in the medical field, where it is currently being used for addiction overdoses and the intake of poisonous substances. OPA member Robert Weber, administrator of Pharmaceutical Services at Ohio State’s Wexner Medical Center, works closely with overdose patients and has experience using activated charcoal during his time as a clinical pharmacist in the intensive care unit.

Remote pharmacy models: Expanding pharmacy's role and reach in the hospital and community?
Becker's Hospital Review
Pharmacists are taking on a much larger role than ever before in hospitals' strategic initiatives. "Historically, pharmacists’ focus was predominantly within the 4 walls of the pharmacy.” says Kelly Morrison, director of remote and retail pharmacy services for Dublin, Ohio-based Cardinal Health. "Their role didn’t involve getting out on the floors working directly with care teams and interacting with patients. That's changed now." As onsite pharmacists take on more initiatives, such as medication reconciliation and discharge patient counseling, the hospital loses valuable labor resources to perform medication order entry and reviews. In these circumstances, remote pharmacy models can be leveraged to offer a convenient and flexible method to supplement onsite pharmacists, according to Morrison. Morrison goes on to explain how "remote pharmacies" are a way to avoid "cost-prohibitive" on-site pharmacists.

Middle schoolers pick Ohio senator's brain during class
Marion Star
What do students and teachers think of their legislators? OPA member & Ohio Sen. David Burke spent some time this week getting answers to that question from his pre-voting age constituents. Burke spent an hour on Wednesday morning talking to a classroom of eighth-grade students at River Valley Middle School, answering questions on subjects ranging from his time growing up in Marion to the war on drugs.

Amazon could enter drug distribution trade: Ohio not among states, yet
Dayton Daily News
Amazon has been picking up licenses around the U.S. to be a wholesale pharmaceutical distributor. The Seattle-based giant that’s been rapidly branching beyond its e-commerce business and into other industries and it now could be setting the stage to enter the pharmacy wholesale business. Amazon has not applied for a wholesale distribution license in Ohio, according to the State of Ohio Board of Pharmacy.

Centers for Families and Children, Circle Health Services announce affiliation to bolster services
Cleveland Plain Dealer
Two social service organizations that have been operating in the Cleveland area for nearly five decades have agreed to an affiliation that they believe will allow them to serve more people.  Circle Health Services, formerly the Free Medical Clinic of Greater Cleveland, and The Centers for Families and Children announced their affiliation this afternoon. The boards for the two organizations each voted unanimously last week to team resources.  The affiliation begins immediately. For The Centers, it opens the door to expand medical services to its clients. For Circle Health Services, it offers some stability and a source of funding if Congress and the Trump administration change or eliminate the Affordable Care Act. 

Rep. Brad Wenstrup: A step towards better healthcare
Clermont Sun
Today, we live in an era of customization. Increasingly, customers can modify a product’s appearance, features, or content according to their unique needs or desires. Often, even the news we see in our newsfeeds is customized based off our preferences. Why, then, are so many aspects of the health care industry still one-size-fits-all? As doctors, we’ve seen firsthand how this can negatively impact patients who require more individualized care. One particular example is a practice known as “step therapy” or “fail first.”

Fentanyl involved in more than half of opioid deaths in 10 states
Pharmacy Practice News
More than 50% of people in 10 states who died of opioid overdoses during the second half of 2016 tested positive for fentanyl, according to a new CDC report. The report found that out of 5,152 opioid overdose deaths in these states, almost 3,000 cases (56.3%) tested positive for fentanyl, and more than 700 tested positive for drugs that have similar chemical structures to fentanyl, including the fentanyl analog, carfentanil, which is 10,000 times more potent than morphine. Carfentanil is frequently used to sedate large animals that can weigh 1,000 lbs or more. OPA member Steven Martin discusses Ohio's inclusion in the list of impacted states.

Communities suing drug distributors want access to transaction information
Canton Repository
A federal judge in Columbus signed an order Friday allowing communities in Ohio and elsewhere that blame drug companies for the opioid crisis to subpoena a national database that tracks the flow of prescription pills. Manufacturers and distributors use the Automated Reports and Consolidated Ordering System (ARCOS) to report their controlled substance transactions to the U.S. Drug Enforcement Administration. U.S. District Judge Edmund A. Sargus Jr., chief judge of the U.S. Southern District of Ohio, based in Columbus, signed the order for the ARCOS data-collection system subpoena Friday. The DEA is likely to oppose releasing the data, said David J. Butler, who is among the attorneys representing the plaintiffs.

Drug pricing madness

States expand price-fixing accusations against generic drug companies
Wall Street Journal
A large group of U.S. states accused key players in the generic drug industry of a broad price-fixing conspiracy, moving on Tuesday to widen an earlier lawsuit. Attorneys general in 45 states plus the District of Columbia and Puerto Rico filed a motion in federal court in Philadelphia on Tuesday proposing to add several more generic-drug companies as defendants in the lawsuit, and to expand the number of drugs at issue to 15 from two. The attorneys general originally filed a lawsuit in December against six companies including Heritage Pharmaceuticals and units of Mylan and Teva Pharmaceutical Industries. The original lawsuit alleged that the companies conspired to manipulate prices for doxycycline hyclate, an antibiotic, and glyburide, used in the treatment of diabetes. Now, the state attorneys general have asked a federal judge for permission to add 12 new companies or corporate entities as defendants in the price-fixing allegations. The states' proposed amended lawsuit says the companies conspired to raise or maintain prices for multiple drugs such as acetazolamide, a glaucoma treatment; meprobamate, an antianxiety drug; zoledronic acid, a treatment for high calcium levels in the blood; and several other drugs.

Flurry of federal and state probes target insulin drugmakers and pharma middlemen
Kaiser Health News
With the price of a crucial diabetes drug skyrocketing, at least five states and a federal prosecutor are demanding information from insulin manufacturers and the pharmaceutical industry’s financial middlemen, seeking answers about their business relationships and the soaring price of diabetes drugs. Attorneys general in Washington, Minnesota and New Mexico issued civil investigative demands this year and are sharing information with Florida and California, according to various corporate financial filings.

Perverse market incentives encourage high prescription drug prices
Pharmacy benefit managers (PBMs) are the under-discussed market participants who manage prescription drug insurance for the vast majority of Americans. PBMs claim to be a lone bulwark against the rapacious pricing decisions of pharmaceutical firms, but is recent consolidation in the PBM market also a driver of high prices for prescription drugs?

“When only a few PBMs exist, it is all too easy for them to stop functioning as brokers that increase market efficiency, and start looking for win-win arrangements in which consumers are the ultimate losers.”

CVS-Aetna deal could have same result as telecom mergers — higher prices
Los Angeles Times
The news that CVS Health is making a $66-billion play for health insurer Aetna inevitably raises two key questions for consumers: What would this do to insurance rates? What would this do to drug prices? At this point, the answer to both questions is nobody knows for sure. We’re heading into uncharted territory. But here’s a thought: Telecom giants AT&T and Comcast are the two largest pay-TV service providers. They’re also purchasing or have already acquired major movie and TV studios, giving them control over both content and the networks that make that content available. Has anyone’s pay-TV bill gone down? Exactly.

CVS-Aetna deal could mean end of era in how drugs are paid for
Bloomberg Markets
If is eventually swallowed by CVS Health, an important part of the health-care business will be changed -- perhaps for good. For years, pharmacy benefits were largely carved out from the rest of a medical coverage plan. But increasingly the two services are being combined, a move that in theory will make it easier to verify whether expensive drugs are worth the cost. A merger of the third-biggest health insurer with the largest U.S. drugstore chain, which also operates a pharmacy-benefit management company, could speed the process. “You are hearing the warning for the end of the road for the classic standalone” pharmacy-benefit business, said Pratap Khedkar, managing principal at consulting firm ZS Associates.

States investigate pharma companies, CVS Health as diabetes drug prices reach record highs
Med City News
With the price of a crucial diabetes drug skyrocketing, at least five states and a federal prosecutor are demanding information from insulin manufacturers and the pharmaceutical industry’s financial middlemen, seeking answers about their business relationships and the soaring price of diabetes drugs. Attorneys general in Washington, Minnesota and New Mexico issued civil investigative demands this year and are sharing information with Florida and California, according to various corporate financial filings. Insulin makers Eli Lilly, Novo Nordisk, Sanofi and top pharmacy benefit manager CVS Health are targets in the state investigations. 


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National pharmacy news

CMS allows more docs to sit out MACRA
Modern Healthcare
The CMS has finalized a proposed rule to exempt more small providers from complying with MACRA. It also reversed course on plans to give providers a pass on gauging whether they are cutting costs under the Merit-based Incentive Payment System, or MIPS.

Hospitals to sue CMS over payment cuts in new 340B rule
Pharmacy Practice News
Three major hospital groups will sue the Centers for Medicare and Medicaid Services (CMS) over a new rule released Nov. 2 which dramatically cuts outpatient drug payments under the federal 340B drug discount program.  The American Hospital Association, America’s Essential Hospitals and the Association of American Medical Colleges say that the changes, which will cost hospitals $1.6 billion in Medicare payments, will threaten access to care.

Opioid epidemic alters prescriber, pharmacist habits
A recent Medscape survey found that 82% of pharmacists and 73% of physicians said that the opioid epidemic has changed their habits around prescribing or filling prescriptions for opioids. A majority said that at some point they had refused to write or fill an opioid prescription. But that refusal came at a cost, with 62% of pharmacists and one-half of physicians saying that they had been fearful about the potential for violence against them by the person requesting the prescription. 

McKesson presses Trump commission to leverage pharmacists, patient safety network to fight opioid epidemic
Healthcare IT News
McKesson is calling on the Trump Administration to implement a number of recommendations to help combat the opioid crisis. In a letter to New Jersey Gov. Chris Christie, the chair of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, McKesson Senior Vice president of Public Affairs Pete Slone laid out some crucial health IT -- and policy needs to begin the fight against the addiction crisis. One major recommendation is for the commission to support a National Patient Safety Network able to identify patients with prescription histories that reveal a higher risk of opioid abuse or misuse than the average patient.

CVS launches new PBM pharmacy network, NCPA responds
Drug Topics
CVS Health announced that it will launch a new performance-based pharmacy network early next year. The National Community Pharmacists Association says that this new network could be good for pharmacists, but the group has reservations about how the network might reward or punish its pharmacies.

EpiPen failures cited in seven deaths this year, FDA files show
Failure of EpiPens to deploy correctly have been cited in seven deaths this year through mid-September, according to reports by patients and physicians made to FDA and obtained by Bloomberg. FDA received a total of 228 reports of EpiPen or EpiPen Jr. failures during the same time period, according to the documents. In addition to the deaths, 35 people were hospitalized. EpiPen and EpiPen Jr. failures resulted in a recall of some units in March by the company that makes the device for Mylan, Pfizer's Meridian Medical Technologies. Mylan, which sells the drug-device combo using Meridian's "pens," called the defect "extremely rare."

Healthcare companies are taking Amazon very seriously
Business Insider
Pharmaceutical companies are fielding a lot of questions these days about Amazon's potential entry into the pharmacy business.  It's enough to spark potential $60 billion+ deals between healthcare giants, and reports of Amazon's actions tangentially related to healthcare have sent healthcare stocks tumbling.  Whether Amazon does enter the business, and if it does, what that business will look like, remains to be seen. There are a lot of people involved in the process of delivering and paying for your prescription, from the drugmakers, to insurers, to the pharmacy. 

Anthem's new PBM predicted to bring cost savings to employers
Insurance giant Anthem Inc. announced this month that it will cut ties with pharmacy benefits manager Express Scripts Holding Co. and is moving to create its own PBM company. It will collaborate with  another major PBM, CVS Health, to form a new PBM called IngenioRx in 2020 when Anthem’s contract with Express Scripts ends. IngenioRx will drive lower prices and give the company the opportunity to offer transparency throughout the pharmaceutical supply chain, according to industry publication Modern Healthcare. Lack of transparency is a common complaint employers have about PBMs.

CVS is plotting a $66 billion takeover — and it has a lot to do with fending off Amazon
Business Insider
Amazon's notorious for stepping into new businesses and crushing the competition with low price, fast delivery, and its massive network of loyal shoppers. When Amazon bought the grocer Whole Foods, shares of other supermarket chains plunged, out of fear they'd be Amazon'd.  Now, the e-commerce giant has its eye on the pharmacy business, and one of the biggest drug retailers — CVS Health — is trying to stay one step ahead. 

Half of patients with super-high cholesterol can't get drugs that could help
When a new class of cholesterol-lowering medications called PCSK9 inhibitors hit the market in 2015, they were instantly controversial because of their price. Amgen’s version, called Repatha, and a rival drug from Regeneron and Sanofi, Praluent, sell on average for $14,300 a year.  Still, the drugs can help patients who cannot lower their cholesterol with traditional statins and therefore face a high risk of developing heart disease.

63% of employers say PBMs not transparent about how they make money
Becker's Hospital Review
Many U.S. employers are concerned about their pharmacy benefit manufacturer's level of transparency, contract complexity and rebate process, according to a report conducted by Benfield on behalf of the National Pharmaceutical Council. Researchers interviewed eight industry experts, including employers, PBMs and pharmacists. Researchers also surveyed health benefit leaders from 88 large U.S. employers in the first quarter of 2017 and later conducted follow-up interviews with eight of the survey participants. Here are four survey findings to know.

Senators move to reduce 'colossal and completely preventable waste' of drugs
Two U.S. senators introduced legislation Tuesday requiring federal agencies to come up with solutions to the waste caused by oversized eyedrops and single-use drug vials, citing a ProPublica story published last month. The bipartisan effort by Sens. Amy Klobuchar, D-Minn., and Chuck Grassley, R-Iowa, calls for the Food and Drug Administration and the Centers for Medicare and Medicaid Services to come up with a plan to reduce the waste, which is estimated to cost billions of dollars a year.

Naloxone reverses 93% of overdoses, but many recipients don't survive a year
As the opioid overdose epidemic continues to surge, public health officials and first responders have turned to naloxone, the drug that reverses overdose, to help combat the rising tide. New research from Brigham and Women's hospital in Boston shows its effectiveness. A review of emergency medical services data from Massachusetts found that when given naloxone, 93.5% of people survived their overdose. The research looked at more than 12,000 dosages administered between July 1, 2013 and December 31, 2015. A year after their overdose, 84.3% of those who had been given the reversal drug were still alive.

The question you need to ask to save on your prescriptions
CBS 58 Milwaukee
Many people assume if they use insurance and get generic medications, they will get the best price on their prescriptions, but that’s not always the case. “The idea of getting insurance is usually so that you can pay less for your prescriptions,” said Dr. Hashim Zaibak, a pharmacist, and owner of Hayat Pharmacies. But did you know, that’s not always the case? Sometimes you pay more using your insurance because of what's called a "copay clawback."

AHRQ compiles online MTM resources all in one place
Pharmacy Today
In July, the Agency for Healthcare Research and Quality (AHRQ) introduced Health Literacy Tools for Providers of Medication Therapy Management, a crosswalk compilation of resources within its online AHRQ Pharmacy Health Literacy Center and elsewhere. The crosswalk is a guide to help pharmacists find tools for each component of medication therapy management (MTM), such as developing medication action plans or providing interventions, referrals, and follow-up.

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